Cryobiopsy in the diagnosis of lung tumors: a single center experience

BACKGROUND: Transbronchial lung cryobiopsy (TLCB) is an endoscopic procedure for tissue sampling in the diagnostic pathway of lung cancer, which has recently been introduced for the sampling of non-interstitial diseases. In this context, also bronchial cryobiopsies (BCs) are used for diagnosis and debulking of endoscopic lesions. The aim of this study was to evaluate feasibility and safety of cryobiopsy for the diagnosis of endobronchial and peripheral lung lesions at high suspicion for lung cancer. METHODS: TLCB and BC were performed under general anesthesia in rigid or flexible bronchoscopy on 20 consecutive adult patients with radiological evidence of central or peripheral lesions, between May 2015 and December 2018. We evaluated the safety profile of the procedure and concordance with other sampling methods concomitantly performed. RESULTS: TLCB and BC allowed the diagnosis in 90% of patients. Cryobiopsy allowed the diagnosis of 85% of cancers and all six benign lesions. Concordance with broncoalveolar lavage (BAL) was 38% and that with transbronchial needle aspiration (TBNA) was 100%. The incidence of severe complications was 2.5% with only a case of pneumothorax, which resolved after chest tube drainage placement. CONCLUSIONS: Cryobiopsy constitutes a safe and useful diagnostic procedure for the diagnosis of lung cancer, with a diagnostic yield of 85%. It allows the collection of large histological samples with a low incidence of severe complications.